Objective: This study evaluated the real-world performance in an Asian population with diabetes mellitus (DM) of the EyeArt system, which is the only United States Food and Drug Administration-approved system available in Hong Kong. Methods: Fundus photographs taken from December 2020 to June 2021 during a diabetic retinopathy (DR) screening program in patients with DM who attended Pamela Youde Nethersole Eastern Hospital in Hong Kong were retrieved. Two vitreoretinal-trained ophthalmologists independently graded the fundus photographs for DR and concomitant pathologies. Discrepancies were resolved through discussion with a senior vitreoretinal ophthalmologist for a final decision. Fundus photographs (in jpg format) were then uploaded to the EyeArt AI system. The EyeArt system's sensitivity and specificity on detecting (1) referable DR (moderate or severe non-proliferative DR, proliferative DR, or diabetic macular edema [DME]) and (2) any DR or DME were calculated based on the ophthalmologists' diagnoses (the gold standard). Results: 23 men and 79 women (93 Chinese, 3 Pakistanis,